Podiatry is the diagnosis and treatment of the foot, ankle and lower extremity structures. Whilst many foot problems respond to non-surgical treatment, some are best treated by Podiatric Surgery.

Podiatrists deal with the assessment, diagnosis and treatment of the lower limb such as arthritis, diabetes, nail surgery and sports injuries. Some Podiatrists who are qualified to undertake nail and soft tissue surgery are also qualified to administer local anaesthetics.

Bunion Surgery

There are a number of surgical procedures for the treatment of bunions. The surgery involved will depend on the severity of the deformity:

Osteotomy

The most common type of bunion surgery which involves cutting bone from the toe. The surgeon removes the bony lump and realigns the bones inside the big toe. They then also move the toe joint back in line, which may involve removing other pieces of bone, possibly from the neighbouring toes. A procedure called distal soft tissue realignment may be combined with an osteotomy. This involves altering the tissue in the foot to help correct the deformity and improve the stability and appearance of the foot.

Arthrodesis

This involves fusing the two bones of the toe and is for patients whose toe is too difficult to fix using an alternative method.

Excision (Keller’s) Arthroplasty

An excision arthroplasty involves removing the bunion and the toe joint. A false joint is created by scar tissue that forms as a result of the operation.The procedure involves pinning the joint in place with wires, which will be removed around three weeks after surgery is carried out.

Hammer, Mallet and Claw Toe

There are a number of different treatments for these fairly common foot deformities:

Arthrodesis (often combined with tendon and skin lengthening)

This is used when the toe is retracted at the joint where the toe joins the foot, and when the toe is very unstable. The problem toe will be dealt with by removing a thin piece of the joint from each side. The two pieces are then held together with Kirchner wires or bone screw in order to set the toe in a straight position. Usually this can be combined with lengthening the tendon on top of the toe, which often becomes tighter and contracted when the toe is retracted.

Arthroplasty

Used to treat hammertoe and mallet toe deformity as above. The problem toe will be dealt with by removing a small piece of bone from one side of the small toe joint. The repair is then completed by interposing the capsule and tendon into the realigned joint to stabilize the toe. The toe may not be completely straight but will be improved.

Correction to Toe Webbing

There are a variety of technqiues that can be used to separate the toes depending on the length of the joined skin involved and how pliable the skin is between the toes. Where necessary a skin graft from the underneath side of the ankle is used to fill in the defect once the toes have been separated.

Ingrown Toenails

A local anaesthetic is used to numb the toe and the edges of your toenail are cut away. A chemical called phenol is applied to the affected area to prevent the nail growing back and becoming ingrown in the future. If the nail is thick and pressing into the skin surrounding the toe then the nail may be removed entirely.

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